Lower Blood Pressure Healthy for the Lower Extremities… and the Heart!

If you have peripheral arterial disease (PAD)—narrowing and hardening of the arteries that supply blood to the legs and feet—and want to lower your risk of a heart attack or stroke, you should aim to keep your blood pressure low, advises a new study.

Researchers studied 950 subjects with type 2 diabetes, 480 of whom had normal blood pressure. All were followed for five years in the Appropriate Blood Pressure Control in Diabetes (ABCD) study in Colorado. Subjects were randomly assigned to moderate blood pressure control (an average blood pressure of 137/81 mmHg) or to intensive blood pressure control (an average of 128/75 mmHg). Fifty-three of the 950 subjects had PAD.

Among those with PAD, three individuals (13.6 percent) who received treatment for intensive blood pressure control experienced a cardiovascular event, compared to 12 events (38.7 percent) among those on moderate treatment.

With intensive blood pressure control, the researchers say—that is, lowering the average blood pressure to 128/75 mmHg—the subjects with PAD reduced their risk of a cardiovascular event to the same level as someone who does not have PAD.

—Circulation, February 11, 2003

Clinical adviser’s note: How was PAD diagnosed in this study? All subjects had an ankle-brachial index measured to compare blood flow in the arm and in the ankle arteries. PAD was defined as an ankle-brachial index less than 0.90.

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